Development of fluid overload has been shown to adversely affect outcomes, including mortality and recovery from acute kidney injury (AKI) in adult and pediatric intensive care units, according to researchers Benjamin Morrow, MD, of the San Antonio Military Medical Center, and collaborators.

The investigaors studied 839 patients admitted to a burn center. Fluid overload, defined as a 10% or greater increase over patients' first recorded weight, was present in 242 (28.8%). In-hospital mortality for the entire group was 10.5%. In-hospital mortality for patients with fluid overload was 22.3% compared with 5.7% for those without overload.

In addition, patients with fluid overload were more likely to AKI than those without overload (78.5% vs. 50%), had greater requirements for renal replacement therapy (RRT, 13.6% vs. 4.8%), and mechanical ventilation (80.6% vs. 46.9%). Although age, need for RRT, AKI, injury severity score, and percentage total body surface area burned independently predicted mortality, fluid overload did not, after adjusting for age and severity of illness.